孟鲁司特钠结合雾化重组人干扰素α1b治疗儿童呼吸道合胞病毒肺炎的效果  

Clinical effects of Montelukast sodium combined with atomized recombinant human interferon alb in children with respiratory syncytial virus pneumonia

作　　者：牡兰 吉木斯古楞 斯琴格日勒 苏布德格日乐 吴春霞[1] 金桃[2] MU Lan;Jimusiguleng;Siqingerile;Subudegerile;WU Chunxia;JIN Tao(Inner Mongolia University for Nationalities Affiliated Hospital,Tongliao,Inner Mongolia 028000,China)

机构地区：[1]内蒙古民族大学附属医院蒙西医结合儿科,内蒙古通辽028000 [2]内蒙古民族大学附属医院呼吸科,内蒙古通辽028000

出　　处：《中华医院感染学杂志》2025年第3期431-435,共5页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区自然科学基金资助项目(2021MS08140)。

摘　　要：目的探讨孟鲁司特钠结合雾化重组人干扰素α1b治疗呼吸道合胞病毒(RSV)感染性肺炎患儿的效果,并分析肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)及Toll样受体4(TLR4)信号通路水平。方法选取2021年2月—2024年2月内蒙古民族大学附属医院收治的118例呼吸道合胞病毒肺炎患儿为研究对象,随机分为研究组和对照组,各59例。比较两组治疗效果、免疫功能、TNF-α、IL-1β及TLR4信号通路因子水平。结果研究组RSV感染性肺炎患儿疗效优于对照组(P=0.020);治疗7 d后两组RSV肺炎患儿Th1、Th1/Th2、CD_4~+CD_(25)~+Treg升高,Th2降低,且研究组Th1、Th1/Th2、CD_4~+CD_(25)~+Treg分别为(24.72±3.08)%、(5.46±0.45)、(11.25±1.29)%高于对照组(P<0.05),Th2为(4.53±2.98)%低于对照组(P均<0.001);治疗7d后两组RSV感染性肺炎患儿TNF-α、IL-1β及TLR4、核转录因子-κB(NF-κB)、NOD样受体热蛋白结构域相关蛋白3(NLRP3)mRNA相对表达量均降低,且研究组以上指标分别为(8.76±1.86)mg/L、(7.20±2.58)pg/ml及(1.02±0.26)、(1.12±0.29)、(1.28±0.31)低于对照组(P均<0.001);两组RSV感染性肺炎患儿不良反应发生率差异无统计学意义(P=0.608)。结论孟鲁司特钠结合雾化重组人干扰素α1b可提高RSV感染性肺炎患儿临床治疗效果,调节免疫平衡,抑制TLR4/NF-κB/NLRP3信号通路激活,降低TNF-α、IL-1β水平。OBJECTIVE To investigate the clinical effect of Montelukast sodium combined with atomized recombinant human interferonαlb in the treatment of respiratory syncytial virus(RSV)infection pneumonia in children,and to analyze levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and Toll-like receptor-4(TLR4)signaling pathway.METHODS One hundred and eighteen children with respiratory syncytial virus pneumonia admitted to the Affiliated Hospital of Inner Mongolia University for the Nationalities from Feb.2021 to Feb.2024 were selected as research subjects and randomly divided into the study group and the control group,with 59 cases in each group.The therapeutic effects,immune function,levels of TNF-α,IL-1β,and TLR4 signaling pathway factors were compared between the two groups.RESULTS The efficacy of children with RSV-infected pneumonia in the study group was superior to that of the control group(P=0.020).After 7 days of treatment,the levels of Th1,Th1/Th2,and CD_(4)^(+)CD_(25)^(+)Treg increased and Th2 decreased in the two groups of RSV-infected children with pneumonia,Th1,Th1/Th2,and CD_(4)^(+)CD_(25)^(+)Treg in the study group were(24.72±3.08)%,(5.46±0.45),and(11.25±1.29)%,respectively,all higher than those in the control group(P<0.05),while Th2 was(4.53±2.98)%,lower than that of the control group(all P<0.001).After 7 days of treatment,the relative expression of TNF-α,IL-1β,TLR4,nuclear transcription factor-B(NF-B),and NOD-like receptor thermal protein domain associated protein 3(NLRP3)mRNA was reduced in children with RSV-infected pneumonia in both groups,and the above indexes in the study group were(8.76±1.86)mg/L,(7.20±2.58)pg/ml,and(1.02±0.26),(1.12±0.29),(1.28±0.31),respectively,all lower than those in the control group(all P<0.001).The difference in the incidence of adverse reactions in children with RSV-infected pneumonia in the two groups was not statistically significant(P=0.608).CONCLUSION Montelukast sodium combined with atomized recombinant human interferonαlb can improve the c

关 键 词：孟鲁司特钠 雾化重组人干扰素α1b 肿瘤坏死因子-Α 白细胞介素-1Β TOLL样受体4 

分 类 号：R563.1[医药卫生—呼吸系统]